An investigation of post-operative morbidity following iliac crest graft harvesting

Objective A study which examined the morbidity experienced by patients who underwent iliac crest bone graft procedures. Design A post-operative questionnaire was forwarded to patients who underwent iliac crest bone graft procedures at a single centre. Subjects One hundred and fourteen patients underwent iliac crest bone grafts for intra-oral augmentation. Results Ninety-eight patients (80%) returned post-operative questionnaires. Eighty of the 98 (81.6%) patients suffered postoperative pain with 70% of patients being pain-free after four weeks. However, 10% of patients experienced pain for more than 16 weeks. Eighty-five (86.7%) patients were able to walk without any difficulties six weeks post-operatively. Gait disturbance was not related with age, however there was a significant association between pain and disturbance of gait (P< 0.001). Twenty two patients required the use of a walking stick and the use of such aids varied from 0.5 to 26 weeks. Women used walking aids for longer periods than men ( P< 0.05). Twenty five patients had altered sensation with about half of them experiencing altered sensation in the distribution of the lateral femoral cutaneous nerve. Other morbidities included deformity at the hip site (2.4%), haematoma ( 2.4%), infection (3.2%), stress fracture (4.1%) and meralgia paraesthetica in one patient. Despite the above morbidities, 82 patients were willing to undergo the same procedure again and 89 patients would recommend the procedure to their relatives and friends. Conclusion This study demonstrates considerable morbidity following anterior iliac crest bone harvest for intra-oral augmentation. Clinicians referring patients for such bone graft procedures must be aware of the above morbidities so that any patients referred for such procedures are fully informed.